Somatic practice, chronic pain and self-care technology: inhabiting the lived and contextual body

Lead Research Organisation: Coventry University
Department Name: Ctr for Dance Research

Abstract

This network brings together experts from dance and somatic practices, health and digital design to explore the living, sensate and subjectively experienced body in context as a means of understanding chronic pain and self-care strategies. Current pain management programmes offer layered treatments, covering physiotherapy, occupational therapy, psychology and medical procedures. Somatic practices have been used in treating pain in private sessions and occasionally in health care contexts (hospital/GP surgery), but are not widespread in being acknowledged as a source of support for those experiencing chronic pain. Somatic practices offer body-mind reflective tools that support taking ownership of one's own bodily experience and finding ways of living with complex conditions. The network seeks to stimulate a dialogue between arts based (dance, media, design) and science based (physiotherapy, occupational therapy, nursing) experts who are both practitioners and academics to explore innovative and transdisciplinary methods for understanding multi-dimensional pain experience in relation to sense-perception and environmental factors. Current pain assessment is often of value in measuring a range of objective outcomes such as increased mobility but is limited in assessing, exploring and understanding the shifting lived experience of those suffering from pain. The lens of assessment also rarely incorporates the layers of knowledge gathered by practitioners (e.g., physiotherapists) or carers (e.g., parents, spouse) through their extended periods of contact with the person experiencing pain. Further, the language of self-care in somatics or self-management in health can have different affects and motivations ranging from more person-centred to more societal ones; for example returning 'expertise' to those with chronic pain, or moving financial and social responsibility from the state to the individual in neo-liberal economies.

Notwithstanding the issues of self management, the representation of lived experience through digital tools can offer methods for recording and analysing disparate layers of experience - visualising personal narratives of pain, sharing health care and somatic perspectives on pain and gathering an array of techniques for living with chronic pain. Somatic practices offer methods for observing and communicating subjective experiences of pain through moving, speaking, writing, and drawing which can be captured using audio-visual means, offering ways of articulating experiences arising from sensation, emotion, thoughts, images, narrative, and so on. Attention to somatic experience also brings with it an awareness of the body in context, revealing the embodiment of social, cultural, economic and political factors. In relation to pain, a sample of these factors include access to care related to gender, race, education and social status; stigmatisation surrounding 'invisible' chronic health problems; and differing beliefs surrounding pain by patients, family members, and healthcare professionals. Somatic approaches offer a means for those experiencing and treating pain to understand better how contextual factors manifest in bodily experience (e.g. what is the somatic experience of not being able to articulate pain or not feeling believed about pain experiences) and to see how socio-cultural issues impact on pain perception, experience and expression.

Planned Impact

The research is of benefit to stakeholders and professionals in the following ways:

Independent somatic movement practitioners
- Develop their practice /skills in chronic pain field
- Provide opportunities for their work to be valued and applied in hospitals/pain management programmes
- Reflect on pain management in the career of the dance artist

Healthcare workers including physiotherapists, occupational therapists, and nurses working with chronic pain
- Develop new knowledge and skills in somatic approaches to movement
- Open up understanding of arts-based and co-creative methods
- Test new creative tools for understanding chronic pain

People living with chronic pain
- Opportunity to include their voice in methods for understanding their experiences
- Learn somatic skills for self care and articulating experiences
- Reflect on digital tools for living with symptoms and mapping changing experiences

Pain management and support organisations such as British Pain Society, The Walton Centre Pain Research Institute, etc.
- New tools and methods for understanding chronic pain and its effects on patients' lives
- Understand innovative new approaches to working with those with chronic pain and stay in touch with developments in the field of research

E-health professionals and organisations
- Test innovation skills and ideas in exploring how dance and somatic movement can be captured
- Explore how new concepts for digital tools can be used to innovate in healthcare settings
- Reflect on how digital tools can be used for mapping experiences, shifting the focus away from measuring 'outcomes'

Publications

10 25 50
 
Title Body awareness 
Description This is a practice video developed in collaboration between Micia de Wet, Tamara Ashley and Rachel Cherry, exploring chronic pain through body awareness, movement and drawing/writing. They address the uniqueness of each person and how they manage their own chronic pain, including the associated emotions. 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact N/A 
URL https://somaticandpain.coventry.domains/practice-body-awareness/
 
Title Breath in energy, breathe out pain 
Description This movement meditation is designed for moving when you are in pain, or when you feel very tired. It is based on Qi Gong, which is a Traditional Chinese Medicine movement practice. Its Taoist philosophy goes back thousands of years and is strongly inspired by nature. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2021 
Impact N/A 
URL https://somaticandpain.coventry.domains/practice-breath-in-energy-breathe-out-pain/
 
Title Children's Chronic Pain: Thinking Outside the Box 
Description In this video interview, pain specialist nurse Jenny McHugh discusses working with children at Alder Hey Children's Hospital with Prof Bernie Carter from Edge Hill University. They talk about the kinds of chronic/persistent pain children present with, and the role of a multidisciplinary team in working with them.By thinking 'outside the box', Jenny has successfully introduced acupuncture into the children's chronic pain service. This is to address not only physical pain, but also associated issues such as sleep loss and anxiety.There is a need for ways to support children and young people to get moving again while experiencing chronic pain - pointing to the potential role that dance and somatic practices could play in the future. 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact Engagement with children's nursing team at Alder Hey Children's Hospital 
URL https://figshare.edgehill.ac.uk/articles/media/Children_s_Chronic_Pain_Thinking_Outside_the_Box/1358...
 
Title Exploring Touch 
Description In this video, we share ideas on touch from the Somatic Practice and Chronic Pain Network, led by Emma Meehan and Bernie Carter. The term 'somatic practices' is introduced, along with the interdisciplinary nature of this research network in exploring dance and health, especially persistent pain. 
Type Of Art Film/Video/Animation 
Year Produced 2020 
Impact It is aimed to open up perspectives on what somatic practices are and the role touch plays, responding to the pandemic. 
URL https://www.youtube.com/watch?v=tRMSA0UikH0
 
Title Fluidity and flow 
Description Lisa Dowler created this 15-minute audio practice for the webinar 'Chronic Pain: The Fear and Joy of Moving'. It explores fluidity and flow in the body, working with a Body-Mind Centering approach. 
Type Of Art Artefact (including digital) 
Year Produced 2021 
Impact N/A 
URL https://somaticandpain.coventry.domains/fluidity-and-flow/
 
Title Moving with Pain and Being The Expert in My Own Body. Ian Tennant interviews Emma Meehan and Bernie Carter. 
Description In this interview Ian Tennant speak to two researchers (Emma and Bernie) from very different backgrounds who have come together to help people living with persistent pain using a type of body-awareness practices known as somatic practice. Dr Emma Meehan has a background in theatre and now works at the Centre for Dance Research, Coventry University, and Professor Bernie Carter started her career in nursing and developed an interest in children living with pain. Bernie now works at the Faculty of Health, Social Care and Medicine at Edge Hill University. We cover some key topics about patient-practitioner relationships including the use of phrases such as 'Wear and tear' which Bernie explains may lead the to patient being cautious and moving less - when actually the healthcare provider may be wanting them to move more. We also talk about the importance of people regaining ownership of their recovery, exploring how to use their body in new ways and finding new meaning for their suffering. This interview is part of the Inner Sense project here: http://www.yourinnersense.co.ukInteroception is the ability to feel what's going on inside our bodies. At a fundamental level, it allows us to know how we feel at any given moment, whether we're hungry, tired or in pain. Dig a little deeper, and this sense can give us more control over how we react to challenges, both internal, external, physical and mental.With resources including interviews and scientifically backed articles, Inner Sense is here to help you discover more about interoception so that you can develop your own bodily awareness and harness its benefits.Find out more about the Somatic and Pain Network on Twitter https://twitter.com/SomaticsandPain 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact over 1000 views on YouTube 
URL https://figshare.edgehill.ac.uk/articles/media/Moving_with_Pain_and_Being_The_Expert_in_My_Own_Body_...
 
Title Self-care practice for parents and carers 
Description The idea for this film came from Lisa Dowler's experience of working with families at Alder Hey Children's Hospital in Liverpool, UK. Many of the children experience pain. She noticed that those taking care of children in pain were often distressed and fatigued and had little time or energy for self-care. They explained that they did not have time to do anything to help them manage their stress and wellbeing. So something simple and short, where they could take time for themselves, would be very useful. This video on self-care for parents and carers is the result. 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact N/A 
URL https://somaticandpain.coventry.domains/selfcare-practice/
 
Title Somatic Practices and Chronic Pain Network 
Description Film introducing the network 
Type Of Art Film/Video/Animation 
Year Produced 2019 
Impact 170 views. 
URL https://www.youtube.com/watch?time_continue=1&v=5Os4Qw7Wxeo&feature=emb_logo
 
Title THROUGH MY EYES, WITH MY BODY 
Description This short film was initiated by Andrea Wright who integrates physiotherapy, pain management, and somatics. Further collaborators and co-authors on this project are artist Ulanah Morris and artist/filmmaker Noorafshan Mirza. The film layers sound, written text, oral conversation, movement, and drawing in the process of reflection. It combines creative exploration, lived experience and intellectual contextualisation. The film invites space to understand, consider, ask questions, be questioned. It is a practice of reflection, revisiting assumptions, engaging in challenge, action, breathing, rest and it is a testament of ongoing work. 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact Engagement of community of black somatic practitioners, people with chronic pain and physiotherapists in a webinar event 
URL https://somaticandpain.coventry.domains/through-my-eyes-with-my-body/
 
Title When things are flowing 
Description Chair based movement practice 
Type Of Art Film/Video/Animation 
Year Produced 2021 
Impact It has garnered 86 views on YouTube 
URL https://somaticandpain.coventry.domains/practice-when-things-are-flowing/
 
Description Somatic practices can be of value for pain management staff, people living with pain and their family members.
Dance and somatic practitioners can work with people living with pain and healthcare professionals to devise valuable approaches to managing pain and expressing pain experiences.
Exploitation Route Article, blog, video and audio practices can be used by dance and somatic practitioners, healthcare professionals and people living with pain as a novel approach to managing pain.
Sectors Communities and Social Services/Policy,Creative Economy,Healthcare,Leisure Activities, including Sports, Recreation and Tourism,Culture, Heritage, Museums and Collections

URL http://somaticandpain.coventry.domains
 
Description Dance artists - skills development and sharing on somatic practices and pain Healthcare professionals - pain management staff workshop, participation in webinars for professional development People living with pain - stakeholder consultation for future project bids, participation in webinars and use of videos for managing pain
First Year Of Impact 2019
Sector Creative Economy,Healthcare,Culture, Heritage, Museums and Collections
Impact Types Cultural,Societal

 
Description Aotearoa Somatic Practice, Chronic Pain, and Design Network: Health Delivery Research Activation Grant
Amount $30,000 (NZD)
Funding ID 20/1283 
Organisation University of Auckland 
Sector Academic/University
Country New Zealand
Start 10/2020 
End 10/2021
 
Description UKRI COVID-19 Grant Extension Allocation
Amount £6,000 (GBP)
Organisation United Kingdom Research and Innovation 
Sector Public
Country United Kingdom
Start 11/2020 
End 07/2021
 
Description Collaboration with Walton Centre Pain Management Programme 
Organisation The Walton Centre
Country United Kingdom 
Sector Hospitals 
PI Contribution We held a workshop for pain management staff on somatic practices
Collaborator Contribution Emma Meehan and Julie Hanna presented information on the network and provided some practical skills.
Impact N/A
Start Year 2019
 
Description Collaboration with Walton Centre Pain Management Programme 
Organisation The Walton Centre
Country United Kingdom 
Sector Hospitals 
PI Contribution We held a workshop for pain management staff on somatic practices
Collaborator Contribution Emma Meehan and Julie Hanna presented information on the network and provided some practical skills.
Impact N/A
Start Year 2019
 
Description Collaboration with the Pain Toolkit 
Organisation Pain Toolkit
Sector Charity/Non Profit 
PI Contribution Emma Meehan and Bernie Carter were interviewed by Pete Moore of the Pain Toolkit on dance for people with pain
Collaborator Contribution The Pain Toolkit hosted the interview on their platform, and posted it on their Youtube, Soundcloud, Twitter accounts.
Impact An online audio interview/podcast. It involves dance and health disciplines
Start Year 2019
 
Description Association of Somatic Movement Dance Therapies UK 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Easing pain & releasing stress

Saturday the 12th & Sunday the 13th of February 2022

A weekend of moving together and sharing approaches to easing pain and managing stress - for health care providers

Practitioners: Dr. Emma Meehan and Prof Bernie Carter, Dr. Melanie Brierley, Dr. Amanda Williamson & Karin Rugman
Times 10-5 each day, with lunch provided. All sessions will be practice-based, with one lecture.

Emma Meehan and Bernie Carter contributed a discussion on the Somatic Practice and Chronic Pain Network and definitions of pain, along with an improvised movement session.
Year(s) Of Engagement Activity 2022
URL https://somaticandpain.coventry.domains/impact-event-4-the-association-for-somatic-movement-dance-th...
 
Description Blog on somatic practices, dance and pain 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact A blog was started during lockdown with interviews, practices, opinions and research on topics ranging from children with pain, physiotherapy research, VR and pain, future project development and rest.
Year(s) Of Engagement Activity 2020,2021
URL https://somaticandpain.coventry.domains/blog-page/
 
Description Bridges Between Dance and Health Blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Purpose to share findings of network to date, and engage with people in performing arts living with pain.
Year(s) Of Engagement Activity 2020
URL http://theatredanceperformancetraining.org/2020/01/bridges-between-dance-and-health-how-do-we-work-w...
 
Description Film Launch Through My Eyes With My Body 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact At this webinar, we launched the film Through My Eyes, With My Body: a creative collaboration documenting the experience of pain and the multitude ways it can be experienced through a Black Woman's perspective.

This short film was initiated by Andrea Wright who integrates physiotherapy, pain management, and somatics. Further collaborators and co-authors on this project are artist Ulanah Morris and artist/filmmaker Noorafshan Mirza.

In the webinar, the artists introduced themselves and their working process. After screening the film, there was a recorded response from Dr. Jackie Walumbe whose research is in physiotherapy and chronic pain management. The event concluded with questions and comments from attendees.
Year(s) Of Engagement Activity 2021
URL https://somaticandpain.coventry.domains/webinar-through-my-eyes-with-my-body/
 
Description Inner Sense 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact This Youtube interview between Ian Tennant, Bernie Carter and Emma Meehan was recorded as part of the Inner Sense Project.

With resources including interviews and scientifically backed articles, Inner Sense is here to help you discover more about interoception so that you can develop your own bodily awareness and harness its benefits.
Year(s) Of Engagement Activity 2021
URL https://www.youtube.com/watch?time_continue=3&v=CK38_jtWv8A&feature=emb_logo
 
Description Mother of All Pain event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Where: Edge Hill University, Ormskirk, Liverpool
When: 15th October 13:30 - 15.30
Approx. 20 attendees

This was a multi-modal workshop to explore pain, exploring how society's most vulnerable communicate pain, without the luxury of language. A unique collaboration between the heart of a nurse, the brain of an artist, and the movement of a dancer to challenge engage and welcome people into this deeply private world.

This event was part of Edge Hill University's annual Festival of Ideas.

Contributors:
Bernie Carter, Professor of Children's Nursing, Edge Hill University.
Rob Young, Artist and Writer.
Emma Meehan, Research Fellow in dance, Coventry University
Year(s) Of Engagement Activity 2019
URL http://somaticandpain.coventry.domains/impact-event-2-mother-of-all-pain-workshop/
 
Description Moving Pain Online 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact This webinar included a panel discussion on how dance and somatic practices can be shared through digital technologies for people living with pain.

Several new videos developed by network members were also launched, which share dance and somatic practices for people living with pain.

Webinar attendees came from all over the UK such as Lancashire, Kent, West Midlands, Cheshire and Hampshire; as well as from countries such as Ireland, Finland, Hong Kong, and Brazil.
Year(s) Of Engagement Activity 2021
URL https://somaticandpain.coventry.domains/movingpainonline/
 
Description NETWORK WORKSHOP 2: DIALOGUES ACROSS DISCIPLINES 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This workshop took place at the Institute for Creative Enterprise at Coventry University on 12-13 September 2019, with 15-20 people attending.
The purpose was to set up knowledge exchange across disciplines of dance and health.

Members shared their work at this workshop including presentations and practical sessions:

Becca Weber - dance, somatics and psychology

Ross Armstrong - systematic review of dance and injury in physiotherapy

Bernie Carter - working with children in pain and their families

Julie Hanna - embodied identity, stories and pain

Tamara Ashley - qualities of touch and experiential meaning

Gina Giotaki - somatic work with pain in health settings

Maria Kapsali - restorative yoga and pain

We discussed how dance and somatic approaches might be incorporated into pain management, and how they could be shared via technology. Further topics that came up include how to incorporate the voices of people who live with pain into the network; and how to communicate our work with wider communities.
Year(s) Of Engagement Activity 2019
URL http://somaticandpain.coventry.domains/workshop-2/
 
Description Network workshop 1: The Living Body in Context 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The purpose was to launch to network, and start an exchange between researchers, artists and healthcare professionals on somatic practices for chronic pain management.

Workshop activities included:
Introduction to the network and getting to know each other
Active Questionnaires on assessment, treatment, attitudes, etc.
Practical somatic movement sessions:
- What are somatic practices?
- Communication, boundaries and power in/through the bodyDiscussions on:
- Value of somatics for pain management
- How this approach could be shared via technology
- Personal, social and cultural context in pain and movement
expression

The workshop took place over two days with participants from dance and somatic practices, healthcare, and digital design (15-20 people). This allowed for a range of perspectives which fed into discussions and practice sessions which explored how somatic movement might support chronic pain management.

This workshop was designed to introduce what somatic practices are, as well as providing a useful starting point for those in different disciplines to be able to talk to one another using a common language.

We asked for feedback via informal conversations, email as well as anonymous questionnaires to inform future directions.
Year(s) Of Engagement Activity 2019
URL http://somaticandpain.coventry.domains/workshop-1/
 
Description Network workshop 3: Somatic practices, technology and pain 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Day 1: Panel and practicals exploring:

What creative ways could we work with somatic practices and technology to support people with pain?

How can somatic movement principles be 'captured' and shared more widely using digital design?

Day 2: Working groups to reflect on the themes and findings of the network to date, and plan future outputs and project ideas.
Year(s) Of Engagement Activity 2020
URL http://somaticandpain.coventry.domains/workshop-3-somatic-practices-technology-and-pain/
 
Description Pain Toolkit Cafe 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact Presentation on dance, somatic practices and pain hosted by Pete Moore at the Pain Toolkit
Year(s) Of Engagement Activity 2021
URL https://www.paintoolkit.org/news/article/pain-toolkit-review-of-2020-and-looking-forward-to-2021
 
Description Somatic Radio 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This interview between Dieter Rehberg, Bernie Carter and Emma Meehan explores what the Somatic Practice and Chronic Pain Network is, the meaning of the word 'somatic' and working across arts and health.

Somatic Radio hosts 'Podcasts on what makes the Body alive'. Founded by Dieter Rehberg, a performer, Psychological Counselor (LSB), Somatic Movement Therapist (ISMETA) Somatic Dance Educator and Massage Therapist. Since 20 years, he works in his private practice in Vienna and teaches nationally and internationally. His main concern in his workshops and seminars is a clear and coherent communication of the content in a mindful atmosphere.
Year(s) Of Engagement Activity 2022
URL https://open.spotify.com/episode/7gqSJk7jtNwPoF2YPh61pq
 
Description Webinar - Chronic Pain: the fear and joy of moving 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact A discussion panel with a physiotherapist, psychologist, dancer and person with lived experience of pain on the theme of 'Chronic pain: the fear and joy of moving'.

An audio practice was shared in advance of the discussion. Polls gathered information from those attending, with comments and questions from participants.

This panel discussion and audio practice aimed to :

- Deepen understanding of fear of moving when living with pain

- Explore how to enhance joy of movement for people living with pain

- Assess how dance and movement practices might be useful/challenging

120 people attended and participated in polls, chat, questions and questionnaire.
Year(s) Of Engagement Activity 2021
URL https://somaticandpain.coventry.domains/the-fear-and-joy-of-moving/
 
Description Webinar: Persistent Pain: Movement and Communication 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Somatic Practice and Chronic Pain Network held a webinar on the topic of Persistent Pain: Movement and (Mis)Communication on 5th of May 2021, 10 am - 12 noon BST.

The main topics included:

(Mis)communication between people living with pain, healthcare professionals and family members
How body and movement are part of this process
The role of dance and somatic practices in articulating pain
How to communicate experiences on moving with pain for future research/practice
The event included short presentations, writing prompts for participants, an optional practice shared in advance, and discussion with panel/ participants.
Year(s) Of Engagement Activity 2021
URL https://somaticandpain.coventry.domains/persistentpain/